Comparative Analysis of Refractive Outcomes Using Optical and Ultrasound Biometry in Phacoemulsification Cataract Surgery

Background: Accurate biometry is critical for optimal visual outcomes in cataract surgery. Both optical and ultrasound biometry are widely used, but their comparative effectiveness remains under evaluation.Objective: To compare the refractive outcomes of optical and ultrasound biometry in patients undergoing elective phacoemulsification cataract surgery.Methods: This prospective cohort study included 352 patients aged 30-60 years undergoing elective phacoemulsification with in-the-bag IOL implantation. Patients were randomly assigned to either optical biometry using the Zeiss IOL Master 700 or ultrasound biometry with Axis Nano contact A-mode echography. Visual acuity and spherical equivalent were measured at baseline and 4 weeks post-operatively. Data were analyzed using SPSS version 25, with independent t-tests comparing outcomes between groups.Results: The mean post-operative visual acuity was 0.83 ± 0.22, with a mean spherical equivalent of -0.88 ± 0.16. No significant difference was found between the ultrasound (-0.89 ± 0.17) and optical biometry (-0.87 ± 0.16) groups (p=0.152, 95% CI -0.06 to 0.01).Conclusion: Both optical and ultrasound biometry provide comparable refractive outcomes in cataract surgery, with no significant difference in post-operative spherical equivalent.